AJR
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Abstract Freely available
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Robinson, P.
Right arrow Articles by Chapman, A. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Robinson, P.
Right arrow Articles by Chapman, A. H.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?
Hotlight (NEW!)
Right arrow
What's Hotlight?

Inguinofemoral Hernia: Accuracy of Sonography in Patients with Indeterminate Clinical Features

Philip Robinson1, Elizabeth Hensor2, Mark J. Lansdown3, N. Simon Ambrose3 and Anthony H. Chapman3

1 Department of Radiology, Leeds Teaching Hospitals, St. James University Hospital, Chancellor Wing, Beckett St., Leeds LS9 7TF, United Kingdom.
2 Department Of Epidemiology, University Of Leeds, Leeds, United Kingdom.
3 Department of Surgery, Leeds Teaching Hospitals, Leeds, United Kingdom.


Figure 1
View larger version (84K):

[in a new window]
  		Fig. 1A —52-year-old man who presented with left inguinal pain; normal findings were seen on sonography. Line drawing (A) and longitudinal sonography image (B) of left inguinal canal show inferior epigastric vessels (IE) laterally, hyperechoic fibrillar inguinal ligament (arrowheads), and transversalis fascia (arrows). Canal contents are fat, nerves, and hypoechoic vessels (asterisks).

 

Figure 2
View larger version (135K):

[in a new window]
  		Fig. 1B —52-year-old man who presented with left inguinal pain; normal findings were seen on sonography. Line drawing (A) and longitudinal sonography image (B) of left inguinal canal show inferior epigastric vessels (IE) laterally, hyperechoic fibrillar inguinal ligament (arrowheads), and transversalis fascia (arrows). Canal contents are fat, nerves, and hypoechoic vessels (asterisks).

 

Figure 3
View larger version (83K):

[in a new window]
  		Fig. 1C —52-year-old man who presented with left inguinal pain; normal findings were seen on sonography. Line drawing (C) and short-axis sonography image (D) of inguinal canal show oval-shaped canal (arrows) containing multiple hypoechoic vessels (small asterisks). Inferior and deep in relation to canal is psoas muscle (P) with rectus abdominis muscle (RAb) superiorly. Posterior and slightly superior to canal is echogenic margin (arrowheads) of transversalis fascia with preperitoneal fat (large asterisk), bowel, and peritoneum deep to fascia.

 

Figure 4
View larger version (119K):

[in a new window]
  		Fig. 1D —52-year-old man who presented with left inguinal pain; normal findings were seen on sonography. Line drawing (C) and short-axis sonography image (D) of inguinal canal show oval-shaped canal (arrows) containing multiple hypoechoic vessels (small asterisks). Inferior and deep in relation to canal is psoas muscle (P) with rectus abdominis muscle (RAb) superiorly. Posterior and slightly superior to canal is echogenic margin (arrowheads) of transversalis fascia with preperitoneal fat (large asterisk), bowel, and peritoneum deep to fascia.

 

Figure 5
View larger version (113K):

[in a new window]
  		Fig. 2A —61-year-old woman who presented with left inguinal pain from left indirect inguinal hernia. Herniography image shows left indirect hernia (arrows) with contrast material filling distally.

 

Figure 6
View larger version (121K):

[in a new window]
  		Fig. 2B —61-year-old woman who presented with left inguinal pain from left indirect inguinal hernia. Longitudinal sonography image obtained while patient was at rest shows inferior epigastric vessels (IE), inguinal ligament (arrowheads), and transversalis fascia (arrows).

 

Figure 7
View larger version (131K):

[in a new window]
  		Fig. 2C —61-year-old woman who presented with left inguinal pain from left indirect inguinal hernia. Sonogram obtained while patient strained shows that hypoechoic hernia (asterisk) arises lateral to inferior epigastric vessels (IE) expanding canal (thin arrows) and displacing ligament (arrowheads) and transversalis fascia (thick arrows).

 

Figure 8
View larger version (146K):

[in a new window]
  		Fig. 2D —61-year-old woman who presented with left inguinal pain from left indirect inguinal hernia. Short-axis sonography image while patient was at rest shows inguinal canal (arrows).

 

Figure 9
View larger version (131K):

[in a new window]
  		Fig. 2E —61-year-old woman who presented with left inguinal pain from left indirect inguinal hernia. Sonogram obtained while patient strained shows that canal is expanded (arrows) by extension of indirect hernia along its long axis.

 

Figure 10
View larger version (179K):

[in a new window]
  		Fig. 3A —73-year-old woman with left inguinal pain from left direct inguinal hernia. Herniography image shows left direct inguinal hernia (arrows) and surgical clips from previous surgery.

 

Figure 11
View larger version (162K):

[in a new window]
  		Fig. 3B —73-year-old woman with left inguinal pain from left direct inguinal hernia. Longitudinal sonography image obtained while patient was at rest shows inferior epigastric vessels (IE), inguinal ligament (arrowheads), transversalis fascia (arrows), and contents including prominent vessel (asterisks).

 

Figure 12
View larger version (153K):

[in a new window]
  		Fig. 3C —73-year-old woman with left inguinal pain from left direct inguinal hernia. Sonogram obtained while patient strained shows that hernia (asterisk) extends (small arrows) through posterior wall defect (margin marked by large arrows) medial to inferior epigastric vessels (IE).

 

Figure 13
View larger version (158K):

[in a new window]
  		Fig. 3D —73-year-old woman with left inguinal pain from left direct inguinal hernia. Short-axis sonography image obtained while patient was at rest shows canal (arrowheads), prominent vessel (asterisk), and transversalis fascia (arrows).

 

Figure 14
View larger version (153K):

[in a new window]
  		Fig. 3E —73-year-old woman with left inguinal pain from left direct inguinal hernia. Sonogram obtained while patient strained shows that hernia (asterisk) enters through posterior wall defect (margin marked by thick arrows) compressing (thin arrows) contents of inguinal canal (arrowheads).

 

Figure 15
View larger version (139K):

[in a new window]
  		Fig. 4A —33-year-old man who presented with right inguinal pain from right posterior inguinal wall bulging. Herniography image shows broad-based bulge (arrows) of transversalis fascia.

 

Figure 16
View larger version (128K):

[in a new window]
  		Fig. 4B —33-year-old man who presented with right inguinal pain from right posterior inguinal wall bulging. Short-axis sonography image of inguinal canal obtained while patient was at rest shows inguinal canal (arrowheads) and psoas muscle (P), with transversalis fascia lying superiorly and posteriorly (arrows).

 

Figure 17
View larger version (128K):

[in a new window]
  		Fig. 4C —33-year-old man who presented with right inguinal pain from right posterior inguinal wall bulging. Sonogram obtained while patient strained shows that bowel (two asterisks) and preperitoneal fat (one asterisk) are displacing intact transversalis fascia (arrows), which is markedly compressing inguinal canal (arrowheads).

 

Figure 18
View larger version (152K):

[in a new window]
  		Fig. 5A —56-year-old woman with right inguinal pain. Herniography findings were false-negative; right indirect hernia was detected at sonography and confirmed at surgery. Herniography image shows no evidence of inguinal hernia.

 

Figure 19
View larger version (155K):

[in a new window]
  		Fig. 5B —56-year-old woman with right inguinal pain. Herniography findings were false-negative; right indirect hernia was detected at sonography and confirmed at surgery. Longitudinal sonography image obtained while patient was at rest shows inferior epigastric vessels (IE), inguinal ligament (arrowheads), and transversalis fascia (arrows).

 

Figure 20
View larger version (163K):

[in a new window]
  		Fig. 5C —56-year-old woman with right inguinal pain. Herniography findings were false-negative; right indirect hernia was detected at sonography and confirmed at surgery. Sonogram obtained while patient strained shows that hypoechoic hernia (asterisk) consisting of fat arises laterally to inferior epigastric vessels (IE), expanding canal (arrows) and displacing inguinal ligament (arrowheads).

 

Figure 21
View larger version (167K):

[in a new window]
  		Fig. 5D —56-year-old woman with right inguinal pain. Herniography findings were false-negative; right indirect hernia was detected at sonography and confirmed at surgery. Short-axis sonography image of inguinal canal while patient was at rest shows round canal (arrowheads).

 

Figure 22
View larger version (169K):

[in a new window]
  		Fig. 5E —56-year-old woman with right inguinal pain. Herniography findings were false-negative; right indirect hernia was detected at sonography and confirmed at surgery. Sonogram obtained while patient strained shows that canal is expanded by extension of indirect hernia (asterisk) along its long axis, which results in compression of other canal contents (arrowheads).

 

Figure 23
View larger version (6K):

[in a new window]
  		Fig. 6 —Flowchart shows clinical outcome for all patients (n = 59).

 

Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?



HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2006 by the American Roentgen Ray Society.